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PhD (Psychology), North-West University, Mafikeng Campus, 2020 Background: The poor mental health and psychological wellbeing of drug addicts, especially users of Nyaope, have continued to raise serious concerns among psychologists, health experts and stakeholders in South Africa. Nyaope has contributed to the development of different psychopathologies among young adolescents, which invariably have negative implications for the general and mental health of many South Africans. This study focused on the link between psychosocial factors (personality, self-esteem, gender, living arrangement and geographical location) and the mental health of Nyaope users. It further examined the mediating effect of psychological wellbeing in the association of personality and self-esteem with mental health. The researcher also sought to determine if users of Nyaope differ significantly from non-users with regard to psychological wellbeing and mental health. Method: This study adopted a cross-sectional, ex post facto research design. A purposive sampling technique was used to select 438 users of Nyaope (273 males; 165 females, mean age = 22.48 ± 2.76) in rehabilitation in five municipalities in the Gauteng Province (Ekurhuleni, Johannesburg, Tshwane, Sedibeng District and West Rand District). Non-users were 443 high school students (218 males; 225 females, mean age = 19.04 ± 1.82) randomly selected from the province. Structured instruments were used to collect data comprising demographic variables, Eysenck Personality Questionnaire-Revised, Rosenberg Self-esteem Scale and Ryff's Psychological Wellbeing Scale. Seven hypotheses were tested using multivariate analysis of variance (MANOVA) and structural equation modelling (SEM). Results: Result showed a significant difference in PWB between users and non-users [Pillai's v = .09, F (6, 874) = 15.18, p < .001, multivariate η2 = .09]. Comparisons of means on PWB subscales indicate that users of Nyaope had lower scores on autonomy, personal growth and self-acceptance than non-users. Also, outcomes showed significant differences in the mental health of users and non-users [Pillai's v = .35, F (4, 876) = 117.68, p < .001, multivariate η2 = .35]. Comparisons of means on mental health subscales indicate that users of Nyaope had higher scores on social dysfunction and more severe depression than non-users. Results of the SEM analyses indicate that self-esteem (β = -.45, p < .001) significantly predicted mental health, while neuroticism (β = .10, p = .08), extraversion (β = .02, p = .74) and psychoticism (β = -.03, p = .59) did not. Specifically, an increase in self-esteem predicted positive mental health. The control variable, gender (β = -.16, p = .003), also significantly predicted mental health. Specifically, being of the female gender predicted negative mental health. The model fit was absolute with a 25% variance in mental health, χ² (19) = 18.96, p = .46; CFI = 1.00; RMSEA = .00 [90% CI = (.00, .04)], SRMR = .02. In addition, self-esteem (β = .24, p < .001) and psychoticism (β = -.16, p = .01) significantly predicted psychological wellbeing while extraversion (β = -.04, p = .49) and neuroticism (β = .05, p = .46) did not. Specifically, an increase in self-esteem predicted positive mental health while an increase in psychoticism predicted negative PWB. The model achieved a satisfactory fitness with 10% variance in PWB, χ² (28) = 86.01, p < .001; CFI = .90; RMSEA = .069 [90% CI = (.05, .086)], SRMR = .06. Outcomes of one step mediation analysis showed that PWB significantly and partially mediates the direct effect of self-esteem on mental health. However, the associations of personality factors with mental health were not mediated by PWB. Results of a two-step mediation analysis further showed that self-esteem and psychological wellbeing successively mediated only the association between psychoticism and mental health. This two-step mediation model was found to be moderated by Nyaope use (yes/no), gender, and living arrangement. The main effect of geographical location [Pillai's v = .08, F (12, 796) = 2.87, p < .001, multivariate η² = .04] was significant on the combined PWB dimensions while the main effects of gender [Pillai's v = .01, F (6, 397) = .44, p = .85, multivariate η² = .01] and living arrangement [Pillai's v = .06, F (30, 2005) = .86, p = .68, multivariate η² = .01] were not. Post hoc analyses indicated that Nyaope users in urban and semi-urban settings had higher scores on autonomy than Nyaope users in rural settings. However, users in rural and semi-urban settings had higher scores on environmental mastery and purpose in life than users in urban settings. The main effect of geographical location (Wilks' ^ = .87, F (8, 798) = 7.18, p < .001, multivariate η² = .07) was significant on the combined MH dimensions while the main effects of gender (Wilks' ^ = .99, F (4, 399) = .55, p = .70, multivariate η² = .01) and living arrangement (Wilks' ^ = .96, F (20, 1324) = .85, p = .65, multivariate η² = .01) did not. Post hoc analyses revealed that Nyaope users in rural and semi-urban settings had lower somatic symptoms, anxiety/insomnia and severe depression scores than users in urban settings. In contrast, users in urban settings had lower social dysfunction scores compared to users in rural and semi-urban settings. Conclusion: It is concluded that Nyaope users have lower psychological wellbeing and poorer mental health outcomes compared to non-users. Higher levels of self-esteem predicted increased PWB and lower mental health problems among Nyaope users. Further, PWB partially mediated the relationship between self-esteem and mental health. Also, self-esteem and psychological wellbeing partly and successively mediated the positive relationship between psychoticism and mental health. This successive mediation was found to be specific for Nyaope users, females Nyaope users, and Nyaope users living under foster care. Lastly, Nyaope users in urban settings appear to have lower PWB and increased mental health challenges compared to users in rural/semi-urban areas. Recommendations: Mental health experts and professionals should assess for Nyaope use among youths presenting with mental health problems so as to understand the aetiology of the problem and the formulation of appropriate treatment plan. Given that this study showed that self-esteem and psychoticism were significant factors in PWB and mental health of Nyaope users, psychologists and other mental health experts should assess for these variables and incorporate psychotherapies aiming at improving self-esteem and lowering manifestation of psychoticism trait especially among female Nyaope users, those living under foster care and in urban centres. Doctoral |
